Experiences with
Eplerenone

Eplerenone is usually taken for heart failure.

It helps to keep your symptoms of heart failure under control and reduce the risk of your heart getting weaker by:

reducing your blood pressure
controlling the amount of salt and water in your body
improving your heart function

It works by blocking the action of a hormone called aldosterone.

Eplerenone comes as tablets and is only available on prescription.

Who can take eplerenone

Most adults aged 18 years old and over can take eplerenone.

Who may not be able to take eplerenone

Eplerenone is not suitable for some people. To make sure it's safe for you, tell your doctor before starting to take it if you have:

ever had an allergic reaction to eplerenone or any other medicine
liver or kidney disease
type 2 diabetes
high levels of potassium in your blood (you'll have a blood test before starting eplerenone to check this)

Dosage

Eplerenone comes as 25mg and 50mg tablets.

The usual starting dose is 25mg once a day, and your doctor may increase it to 50mg once a day.

Your dose may also change depending on the level of potassium in your blood. If your blood test shows you have too much potassium in your blood, your doctor may reduce the dose or tell you to take it every other day. Or they may ask you to stop taking eplerenone for a short time.

How to take it

You'll usually take eplerenone once a day. Try to take it at the same time every day. This makes it easier to remember when to take your medicine.

Swallow the tablets whole with a drink of water. You can take eplerenone with or without food.

How long to take it for

You'll usually take eplerenone long term, possibly for the rest of your life.

If you forget to take it

If you forget to take a dose of eplerenone, take it as soon as you remember on that day.

If you forget your dose for the whole day, skip the missed dose and carry on as normal the next day.

Do not take 2 doses at once to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking too much eplerenone can:

make you feel sick or be sick, or have diarrhoea
cause low blood pressure and make you feel confused or dizzy, sleepy, weak, lightheaded or have blurry eyesight
raise your potassium levels and cause a tingling feeling, muscle cramps or weakness
cause an unusual heartbeat or chest pain
make you feel short of breath

You take more than your prescribed dose of eplerenone and:

you have an irregular or fast heartbeat (your heart feels like it's pounding or is beating a lot faster than normal)
you have chest pain – this needs to be checked out as chest pain is a possible sign of a heart attack

you take more than your prescribed dose of eplerenone even if you do not have symptoms

Call 111 or get help from 111 online .

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the eplerenone packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of eplerenone happen in more than 1 in 100 people. They're usually mild and do not last long. There are things you can do to help cope with them:

If eplerenone makes you feel dizzy, especially when you stand up, stop what you're doing and sit or lie down until you feel better. Do not drive, ride a bike or operate machinery.

If this continues for more than a few days, speak to your doctor as you may need your potassium levels checked.

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if the headaches do not go away or are severe.

Avoid caffeine (such as tea, coffee, cola, energy drinks and chocolate) in the afternoon and evening. Keep your bedroom dark and quiet, and try going to bed at the same time each day. Try not to watch TV or use your mobile phone before going to bed. Instead, try to relax for an hour before bedtime.

Sometimes, your cough will get better on its own. Talk to your doctor if it carries on, bothers you, or stops you sleeping.

Take eplerenone with or just after a meal.

If you're being sick, take small, regular sips of water or squash so you do not get dehydrated (ask your doctor how much fluid you can drink). Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

If you take the combined contraceptive pill or the progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

You can also talk to your doctor or pharmacist if the advice on how to cope does not help and these side effects bother you.

Serious side effects

Serious side effects after taking eplerenone are less common and happen in less than 1 in 100 people.

Call your doctor or call 111 straight away if:

you have muscle cramps, diarrhoea, or feel sick or weak – your potassium levels may have increased and you may need a blood test
you're peeing less than usual or have dark, strong-smelling pee, feel thirsty or feel dizzy or light-headed – these can be signs of dehydration
you have diarrhoea, are peeing less than usual, are feeling or being sick, and feel drowsy or confused – these can be signs of loss of kidney function

you have an irregular or fast heartbeat (your heart feels like it's pounding or is beating a lot faster than normal)
you have chest pain – this needs to be checked out as chest pain is a possible sign of a heart attack

Meds - serious side effects A&E safety messaging

In rare cases, eplerenone may cause a serious allergic reaction (anaphylaxis).

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of eplerenone. For a full list, see the leaflet inside your medicine packet.

Eplerenone and pregnancy

Eplerenone is occasionally prescribed in pregnancy, for some medical conditions.

If you take eplerenone and are trying to get pregnant or are already pregnant, talk to your doctor about whether continuing it is right for you. They can tell you about the benefits and possible risks of taking eplerenone, and suggest other medicines that may be better for you.

Eplerenone and breastfeeding

If your doctor or midwife says your baby is healthy, you can take eplerenone while you're breastfeeding. However, other medicines might be better.

The small amount of information available on taking eplerenone while breastfeeding shows that it passes into breast milk in very small amounts. It might be better to take a medicine that has more information about use in breastfeeding. Talk to your doctor or pharmacist first, and they'll help you decide.

Your doctor may still recommend eplerenone, as it's important to treat your medical condition to keep you well. Breastfeeding will also benefit both you and your baby.

Talk to your health visitor, midwife, doctor or pharmacist or call 111 as soon as possible if you have any concerns. This includes if your baby:

has changes to their usual feeding
seems irritable, including struggling to sleep
seems unusually tired
has an upset stomach, for example is being sick or has diarrhoea
has constipation
has skin rashes

Eplerenone and fertility

There's no evidence to suggest that taking eplerenone affects fertility in men or women.

Talk to your doctor if you're trying for a baby or having problems getting pregnant while on eplerenone.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Speak to your doctor or a pharmacist before starting eplerenone if you take any of the following:

high blood pressure medicines like ramipril, enalapril, losartan or candesartan
tacrolimus or ciclosporin, used to treat skin conditions such as psoriasis or eczema
antibiotics, such as trimethoprim, clarithromycin, erythromycin or rifampicin
medicines to treat HIV
digoxin or amiodarone – used for heart conditions
lithium – used to treat bipolar disorder
painkillers such as diclofenac, ibuprofen, naproxen or aspirin
medicines to treat fungal infections such as itraconazole or fluconazole
medicines for epilepsy, such as phenytoin, carbamazepine or phenobarbital
spironolactone or amiloride – medicines that affect your potassium levels
warfarin – a medicine to prevent blood clots

Mixing eplerenone with herbal remedies and supplements

St John's wort, a herbal medicine taken for depression, can affect how eplerenone works. Talk to your doctor if you're using it or planning to use it.

Do not take any potassium supplements, including salt substitute tablets. Taking these with eplerenone can cause your potassium levels to become too high. Some multivitamin and mineral supplements contain potassium. Always check the label.

There's not enough information to say that other complementary medicines, herbal remedies and supplements are safe to take with eplerenone. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert